Imaging Utilization During Explosive Multiple Casualty Incidents

Abstract

These results are significantly different from previous reports and indicate that victims of explosive MCIs will require more imaging, especially CT, than previously anticipated. These data will allow improved integration of radiology staffing and resource allocation into disaster management plans designed to prepare for future explosive MCIs.

Terrorist Bombings: Foreign Bodies from the Boston Marathon Bombing

“…4,6,7 Radiology departments should maintain a comprehensive mass casualty plan to address the surge in imaging needs that arise from blast injuries. This may require mobilization of additional portable imaging equipment or cancellation of nonemergent imaging on CT scanners or nearby fixed x-ray units to create additional capacity.…”

“…The severity of blast injuries is a function of the energy of the explosive device, the use of shrapnel and other morbidity-enhancing agents (ie, toxins), proximity to the device, and the placement of device, open vs closed space. 3,4 Primary Blast Injuries Primary blast injuries are caused by barotrauma resulting from the initial pressure wave. The most common types of injuries involve air-filled organs and air-fluid interfaces because of dynamic pressure changes at tissue-density interfaces.…”

Guidelines for Burn Care Under Austere Conditions

“…Faced with multiple victims with injuries from head to toe, the ability to rapidly evaluate by CT scan is invaluable. 19,20 This resource, however, is a potential bottleneck in a mass casualty scenario and may be unavailable in an austere environment. Traumatic Brain Injury.…”

Point-of-Care Ultrasonography in a Domestic Mass Casualty Incident: The Boston Marathon Experience

“…Traditional radiology imaging resources were overwhelmed during this incident 15 and have been shown to be heavily utilized in other MCIs. 4 The ability to perform rapid bedside POC ultrasonography provided crucial clinical information early on given significant delays in obtaining plain radiography studies or CT scans due to the large surge of patients. POC ultrasound was also described as a triage tool in patients awaiting CT scans or operative intervention.…”

“…[1][2][3][4][5][6][7][8] POC ultrasonography plays an increasingly important role in emergency medicine training and patient care. 9 Additionally, POC ultrasonography has been incorporated into routine trauma management and is considered standard of care.…”